Journal
JOURNAL OF RENAL NUTRITION
Volume 30, Issue 4, Pages 347-359Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.jrn.2019.07.006
Keywords
-
Categories
Ask authors/readers for more resources
Objective: This systematic review and meta-analyses provide an up-to-date synthesis on the effects of supplementation on circulating levels of toxic metabolites, markers of uremia and inflammation, blood lipids, and other clinical outcomes. Methods: Seventeen databases were searched, supplemented with internet and hand searching. Randomized controlled trials of adult end-stage renal-disease individuals receiving either hemodialysis or peritoneal dialysis were eligible. Trials were restricted to those which had administered a prebiotic, probiotic, or synbiotic as an oral supplement. Primary outcomes were measures of circulating endotoxin, indoxyl-sulphate, and p-cresyl sulfate. Results: Twenty-one trials were eligible (1152 randomized participants), of which 16 trials were considered to have a high risk of bias. The number of trials available for meta-analysis varied for each primary outcome. Synthesized data indicated that supplementation significantly reduced circulating levels of endotoxin (standardized mean difference, -0.61; 95% confidence interval, -1.03 to -0.20; P = .004; I-2 = 0%), indoxyl-sulphate (-0.34; -0.64 to -0.04; P = .02; I-2 = 0%), and p-cresyl sulfate (-0.34; -0.61 to -0.07; P = .01; I-2 = 0%). For secondary outcomes, supplementation significantly reduced gastrointestinal symptoms (-0.54; -1.02 to -0.07; P = .02; I-2 = 0%). Conclusions: Supplementation reduces toxic metabolites associated with cardiovascular disease and mortality in individuals receiving dialysis. However, the majority of trials included were low in quality. (C) 2019 by the National Kidney Foundation, Inc. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available